When should pterygium be surgically removed?

When should pterygium be surgically removed?

• A. If encroaching on the visual axis or before cataract surgery
• B. For every case
• C. Only if symptomatic itching
• D. Never

Answer: (A)

Removal is timed to prevent vision loss or refractive complications. A pterygium can distort the central cornea and induce astigmatism when it reaches or encroaches on the visual axis, directly affecting vision. If a patient is planning cataract surgery, removing the pterygium beforehand helps ensure accurate keratometry and IOL power calculations, reducing the risk of postoperative refractive surprises. For small, stable pterygia that do not threaten the visual axis, observation is appropriate. Symptoms like itching alone do not justify surgery; treatment focuses on comfort and controlling inflammation. So the best indication to operate is when the pterygium encroaches on the visual axis or before cataract surgery to protect and optimize vision.

Removal is timed to prevent vision loss or refractive complications. A pterygium can distort the central cornea and induce astigmatism when it reaches or encroaches on the visual axis, directly affecting vision. If a patient is planning cataract surgery, removing the pterygium beforehand helps ensure accurate keratometry and IOL power calculations, reducing the risk of postoperative refractive surprises. For small, stable pterygia that do not threaten the visual axis, observation is appropriate. Symptoms like itching alone do not justify surgery; treatment focuses on comfort and controlling inflammation. So the best indication to operate is when the pterygium encroaches on the visual axis or before cataract surgery to protect and optimize vision.